Why Your MRI Might Not Explain Your Whole Back Pain Story
We get it—when you're experiencing back pain, seeing an X-ray or MRI of your spine can reassure you that there is a reason for your pain. There's something tangible about holding an image in your hands, pointing to a specific spot, and saying "that's where it hurts." As one newer study noted, patients frequently find "it's hard to trust an individual, it's easier to trust an image" when dealing with the vagueness of low back pain. (1) However, as your trusted chiropractic partncer at Dr. Le's Chiropractic & Wellness, L.L.C., we need to share an important fact: imaging doesn't always expose the real cause of your discomfort.
THE IMAGE-PAIN DISCONNECT
Research steadily shows a remarkable disconnect between what appears on imaging and what patients really feel. A comprehensive 2025 systematic review assessing lumbar spinal stenosis—a condition that entails narrowing of the spinal canal—found that imaging findings don't dependably predict long-term outcomes or symptom severity. (2) Many patients with significant stenosis seen on MRI have minimal pain, while others with minimal imaging changes suffer considerably.
Studies have also shown that many people without any back pain have disc bulges, herniations, and arthritis visible on their MRIs. If we depended solely on imaging, we might treat findings that are not actually causing problems while [[missing}overlooking]31] the true source of your symptoms.
This isn't to ignore imaging entirely. Rather, it highlights why your clinical examination is equally—if not more—important. When your chiropractor assesses your movement patterns, muscle strength, reflexes, and pain response to specific positions, they are gathering critical information that images just cannot suppy.
THE COMPLETE CLINICAL PICTURE
Think of imaging as one chapter in your health story, not the entire book. Your MRI might show disc bulges or arthritis, but these findings are incredibly common in pain-free individuals too. What matters most is how your spine functions, not just how it looks.
This is where your chiropractor's expertise becomes invaluable. By incorporating imaging findings with hands-on examination, movement assessment, and your symptom history, they come up with a full understanding of your pain issue. This balanced approach leads to more precise diagnosis and applicable treatment plans tailored to your specific needs, rather than just treating what appears on a scan.
TRUST THE PROCESS
Yes, uncertainty can be uncomfortable, and wanting concrete answers through imaging is completely natural. But trust that your clinical evaluation at Dr. Le's Chiropractic & Wellness, L.L.C.—combined with thoughtful interpretation of any imaging—offers the most complete picture of your spinal health. Together, we’ll come up with a treatment strategy based on the best available evidence and your individual presentation, not only the images.
CONTACT Dr. Le's Chiropractic & Wellness, L.L.C.
Listen to this PODCAST with Dr. Mary Peterson on The Back Doctors Podcast with Dr. Michael Johnson as she describes the benefit of the system of Cox® Technic that guides care of spine pain for best relief.
